Individual provider Active NPI

Adesoji Ajala, NP

  • Family Nurse Practitioner
  • Littleton, CO
National Provider Identifier
1063190825
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0998722-NP Issued in CO
Practice address
5822 S Lowell Way
Littleton, CO 80123-2849
Phone
(720) 669-3470
Fax
(720) 669-3480
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0998722-NP CO
Family Nurse Practitioner 363LF0000X APN.0998722-NP CO Primary

Addresses

Primary practice location

5822 S Lowell Way
Littleton, CO 80123-2849

Mailing address

8181 E Tufts Ave Ste 560
Denver, CO 80237-2559
Phone (720) 669-3470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725000166 CO Practitioner - Nurse Practitioner 3870988199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0998722-NPCOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green Springs Medical and Healthcare Inc Current Accepting new patients
Forte Health and Wellness Inc Nurse Practitioner Current Accepting new patients
Arise Support Services LLC PastSince May 8, 2020 Accepting new patients

Locations

8181 E Tufts Ave
Ste 560
Denver, CO 80237
Phone (720) 669-3480

5822 S Lowell Way
Littleton, CO 80123
Phone (303) 798-2497

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arise Support Services LLCDenver, CO, CCN 067617 Home health agency 5% Or Greater Direct Ownership Interest (50%)
W-2 Managing Employee
Operational/Managerial Control
May 8, 2020
May 8, 2020
May 8, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1063190825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8181 E TUFTS AVE STE 560",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802372559",
            "telephone_number": "720-669-3470",
            "fax_number": "720-669-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5822 S LOWELL WAY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801232849",
            "telephone_number": "720-669-3470",
            "fax_number": "720-669-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJALA",
        "first_name": "ADESOJI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0998722-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998722-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.